Access to clean water, sanitation and hygiene (WASH) in healthcare facilities is a fundamental component of public health and supports the delivery of safe, quality healthcare services for all.

WASH transforms how people receive and provide healthcare. Without access to WASH, healthcare workers are unable to practice proper hygiene behaviors and the morale and motivation of healthcare workers decreases. They are unable to provide quality care and therefore staff retention, particularly in rural areas, becomes challenging.  

In Tanzania, the dangers posed by insufficient access to WASH is a reality for millions of people. Nearly half of the population does not have access to clean water and 80% do not have access to a decent toilet. In 2016, WaterAid began the project as part of the Canada-Africa Initiative to Address Maternal, Newborn and Child Mortality in Sub-Saharan Africa, a partnership among four Canadian organizations jointly funded by the Government of Canada. This four-year program improved reproductive, maternal, newborn and child health (RMNCH) through the provision of water, sanitation and hygiene services at twelve obstetric and neonatal healthcare facilities across the Geita and Nyang’hwale districts of northern Tanzania.

Key Stats:  

  • Number of community health workers trained on the provision of gender-sensitive services and best practices in WASH: 1,906 

  • Number of Community members reached through education and awareness-raising campaigns on available WASH services: 729,093 

  • Number of community change agents identified, trained and mentored to influence peers on positive WASH practices, including the impact of gender: 878 

  • Number of members of women-led community water and environmental management committees: 247 

Nurse holding a baby
Grace Nabenga Lufu, 31, a nurse, with a healthy three-hour old baby girl after medical examination. She says now that the labour room has access to safe water, her work is more easy and enjoyable.
Image: WaterAid/ James Kiyimba

Bringing WASH to Healthcare Facilities 

WaterAid works to transform the lives of the poorest and most marginalized communities by improving access to WASH. Central to Tanzania: Deliver Life was the construction and rehabilitation of WASH infrastructure at 12 healthcare facilities, which has brought running water, flushing toilets and handwashing stations to the maternity wards, operating rooms and other areas within the facility. 

Without WASH services, healthcare workers are unable to practice good hygiene behaviors, such as handwashing with water and soap. Clinics cannot be kept clean — medical equipment and bedding go unwashed and medical waste cannot be safely disposed of. Additionally, lack of WASH access means that patients, especially pregnant women, are less likely to bring their healthcare issues to clinics. After , these healthcare facilities are now better able to serve their communities, leading to better health outcomes. The clinics are supported by sustainable equipment like solar-powered boreholes, rainwater harvesting and UV disinfection systems which provide a clean, accessible and consistent water supply. At the end of the project, all 12 healthcare facilities had access to running water and soap in the delivery room. As the facilities gained access to clean water and thus better hygienic capabilities, there was a significant increase in the proportion of women who delivered in a facility with a clinician, nurse or midwife and a substantial reduction in the proportion of women who delivered at home. Before the intervention, only 59% of women surveyed had a skilled birth attendant (SBA) present during the birth process. After the intervention, that statistic rose to 78%, a signal that the healthcare facilities were better able to serve their communities.

Women holding up her hands after washing them
Dr. Queen Kulwa Machella, 24, clinical officer, raising her hands after washing them to signify that clean hands save lives, Nkome Dispensary, Geita District, Tanzania, June, 2019.
Image: WaterAid/ James Kiyimba

Increasing Sanitation and Hygiene Infrastructure

Alongside our work in the 12 healthcare facilities, WaterAid’s work in Tanzania also increased the availability of sanitation and hygiene infrastructure in the surrounding community. Before , only 17% of surveyed individuals had access to toilets and 43% had soap in their homes. After the project’s completion, the proportion of people with access to improved sanitation rose to 27%, with individuals having increased access to piped sewer systems, septic tanks and other improved infrastructure. In the post-project survey, the presence of soap in homes rose to 83%, a significant increase.

Empowering Women and Girls

Supporting maternal, newborn and child health through infrastructure and education impacts female empowerment. With greater trust in health services and improved knowledge of the choices available, women and girls can better address their health concerns, especially ones related to childbirth and childcare. To measure the project’s impact on female empowerment, women were asked whether they would decide to seek medical care on their own or jointly with a partner/husband (as opposed to at the sole discretion of their partner). Baseline figures found that 23% of adolescent women and 48% of adult women would do so. After , those statistics rose to 59% and 61% respectively.  

Improving Hygiene

Good handwashing practices make up the bedrock of strong healthcare services.  Because of this, hygiene promotion was one of the top priorities of . Twelve villages took part in a campaign that educated community members on key hygiene behaviors. The training focused on behavioral change and the value of handwashing and latrine use, as well as creating a greater understanding of WASH-related diseases and the safe water chain. The program reached 729,093 individuals and was created and executed in collaboration with the local communities, ensuring sustainable and long-lasting success. Synthesizing this training with access to material hygiene resources like soap and water is a pillar of WaterAid’s programming.  

Group of people sitting in a semi-circle
Jonathan M. Mhogota, 65, Nyamalimbe Village Chairman in meeting with village health team members, Nyamalimbe Village, Geita District, Tanzania, June 2018.
Image: WaterAid/ James Kiyimba

WaterAid in Tanzania

Nearly half of the population in Tanzania have no clean water, and less than a quarter have a decent toilet. However, the Tanzanian Government has ambitious goals to deliver clean water and toilets to a significant portion of its population. complements Government initiatives and WaterAid’s other programming in Tanzania building toilet blocks in schools, encouraging higher enrollment, and ensuring that girls can manage their periods safely and privately. Learn more about WaterAid's work in Tanzania on the WaterAid Tanzania website